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Royal Sussex County Hospital
Requires improvement

CQC carried out a period of listening activity at Brighton and Sussex University Hospitals NHS Trust in December 2013 and January 2014. The report from that exercise, which informed our inspection in May 2014, is available below.

Overview and CQC Inspections

OverallRequires improvement

Our inspector's description of this service

Last updated 10 August 2017

Brighton and Sussex University Hospitals (BSUH) is an acute teaching hospital with two sites, the Royal Sussex County Hospital in Brighton (centre for emergency and tertiary care) and the Princess Royal Hospital in Haywards Heath (centre for elective surgery). The trust does not have Foundation trust (FT) status.

The trust has a total of 1,069 beds spread across various core services:

484 Medical beds (438 Inpatient, 46 day case)

360 Surgical beds (338 Inpatient, 22 day case)

105 Children’s beds (79 Inpatient, 26 day case)

79 Maternity beds (79 Inpatient, 0 day case)

41 Critical Care beds (41 Inpatient, 0 case)

25 A&E beds

The Brighton campus includes the Royal Sussex County Hospital, the Royal Alexandra Hospital and the Sussex Eye Hospital. The whole site is currently undergoing a major redevelopment and major building works were in progress at the time of our inspection.

The trust provides district general hospital services to local populations in and around the Brighton and Hove, Mid Sussex and the western part of East Sussex and more specialised and tertiary services for patients across Sussex and the south east of England. The trust primarily serves a population of over 750,000 people.

The health of people in Brighton and Hove is varied compared to the England average. Deprivation is similar to the England average and about 17% (7,400) children live in poverty. Life expectancy for both men and women is lower than the England average.

In the latest financial year, April 2015 to March 2016, the trust had an income of £529m and costs of £574m, a deficit of £45m for the year. The trust predicts that it will have a deficit of £59m in 2016/17.

We inspected the trust in April 2016 and rated the trust and the Royal Sussex County Hospital as inadequate. The trust was subsequently placed into special measures by NHS improvement. This inspection was performed to assess progress at the trust following eight months of performance oversight as part of special measures.

After a period of instability at executive level, management arrangements for the trust passed to the board of Western Sussex Hospitals Foundation Trust on 1st April 2017. Therefore it was not appropriate to carry out a assessment of the trust-wide leadership.

We inspected the core services of emergency care, medical services, surgery, critical care, maternity and gynaecology and outpatients and diagnostics. We did not inspect end of life care as this was rated good in 2016, nor did we inspect children and young people's services as these had been rated as outstanding at our previous inspection. We have retained the ratings for these services from the 2016 inspection for the purposes of aggregating ratings.

Inspection ratings

We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels:

Outstanding – the service is performing exceptionally well.

Good – the service is performing well and meeting our expectations.

Requires improvement – the service isn't performing as well as it should and we have told the service how it must improve.

Inadequate – the service is performing badly and we've taken enforcement action against the provider of the service.

No rating/under appeal/rating suspended – there are some services which we can’t rate, while some might be under appeal from the provider. Suspended ratings are being reviewed by us and will be published soon.

Ticks and crosses

We don't rate every type of service. For services we haven't rated we use ticks and crosses to show whether we've asked them to take further action or taken enforcement action against them.

There's no need for the service to take further action. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service.

The service must make improvements.

At least one standard in this area was not being met when we inspected the service and we have taken enforcement action.